Report on Care of Elderly is Really Shocking

Your correspondent as just finished reading a new 30-page report (in Finnish only) how a private company called Esperi Oy has cared for thousands of elderly patients in their care homes.

The report is a description of scandalous and callous behaviour by a big company that has lasted for years, and is still ongoing. They should know better – there can be no excuses…

This company is owned 80% by a British private equity company, and by one of the largest Finnish pension companies that has a 4% ownership. The remaining part is owned by the management and friends…

Esperi Oy is one of the largest companies in Finland that is caring for the elderly under public contracts. They have contracts with over 200 municipalities throughout the whole country.

The report was commissioned and paid for by Espri Oy to examine and assess the quality of care given to their patients and to give recommendations for improvements in the quality of care. An eminent group of professors and specialists were appointed to prepare the report.  

The background to the report were serious complaints about the poor standard of care made against Esperi and some other care providers in the private and public sectors starting some four years ago in 2016.

These complaints were investigated by the relevant government authorities, Valvira, and as a result of these investigations Valvira shut down one of the company’s homes located in Kristiinankaupunki in the west of Finland.

“The weaknesses identified were related, inter alia, to the number of inadequate medical staff in relation to the assessment of care and care needs, lack of basic care, the appropriateness of drug treatment, lack of care information for clients, and the work of close staff of the functional unit,” Valvira said in a statement.

They have also been many other reports in the press about other similar serious failures in delivering proper care to the patients of Esperi Oy and a few other private and public companies. Similar experiences have been seen in Sweden, and there are now demands that profit-seeking private companies should not be allowed to have an active role in this market, which many professionals see as belonging solely to the province of the public and third sector.

After a thorough reading of the report and related other documents, your correspondent has come to the following conclusion:

The present state of affairs in Esperi Oy is nothing more than shocking, and that the recommendations made in this report are most probably a collection of wishful thinking by a group of eminent geriatric specialists, who unfortunately do not fully understand that the present ownership structure has no interest other than making a great deal of money from Finnish taxpayers in a legal but immoral manner.

It should be stated quite clearly that the writers of the report are leading experts in geriatric care. They have dutifully reviewed and assessed the standard of care at the company’s care homes in various towns and cities in Finland. These highly qualified experts have come to the conclusion that the standard of care in many of the care homes is well below what is acceptable and they have made many recommendations to the company.

The experts state that the company has clear written guidelines to maintain generally accepted care standards and adhere to certain work processes. However, the report discloses that in many cases the experts found that that written instructions and processes had not been implemented and that many patients continue to be subjected to sub-standard and unacceptable levels of care. 

One can summarise the report’s conclusions as follows:

  1. Care was still inadequate and neglectful in many care homes. This is particularly disturbing because some 70% of the patients as said to be demented, most of whom are seriously so.
  2. Access to proper healthcare is limited at night and during weekends, according to the report. Doctors have often give care instructions to staff without ever meeting patients! 
  3. Work schedules and processes have been badly managed leading to weary and over-worked workers.
  4. Staff turnover has been high, because of poor working conditions with many recruits being paid minimum wages.
  5. Foreign workers have been employed without adequate language skills.
  6. Food in many cases has been substandard. It appears that food is an area of cost saving too.
  7. Many patients have been unable to move around freely.
  8. Expansion and revenue growth have been the major objectives of this company without proper planning.

The report does not cover the ownership history or the current ownership situation, and this is a serious omission. The former owner is the CEO and founder  of Esperi Oy who together with Capman Oy, one of the biggest Finnish investment companies, expanded the company rapidly by acquiring smaller care companies. They then sold the company last year for €220 million to Intermediate Capital Group, (ICG), a British private equity investor fund management group, that seeks to maximise profits by buying companies with high levels of expensive debt and by minimising taxes though aggressive but legal tax avoidance schemes.

Their modus operandi is to milk the largest possible profits from the company while pumping fast growth and then selling it off at a profit as quickly as possible. Looking at their website and reading through their most recent annual report, there is no mention of caring for the elderly or looking to develop basic health care services. Their only concern is profit maximisation, something that is in complete contradiction to needs of patients of Esperi Oy.

A minority shareholder is also Imarinen, the largest pension company in Finland, makes the following claims: “Our task is to ensure that our customers receive the pension they earned from employment. We also seek to improve working life and thus help our customers succeed.” In other words they do not care any more once you retire and live in one of their care homes! They did nothing to ensure proper care for years as a shareholder even though media reports were plentiful about neglect.

The current ownership organisation by ICG ensures that they do not pay any taxes in Finland or in fact almost anywhere in the world. Such tax avoidance by companies like Esperi Oy for public services is totally unacceptable because the costs of patients in the Esperi’s care homes are paid by Finnish taxpayers.

As stated above it appears that the experts were paid by the company to write a report with recommendations that would satisfy the regulator and the general public. However as seen over the last few years, very little has been done by the private care companies to improve their neglectful activities. Even the regulator appears to have too few resources to review and sanction neglectful private care home operators.

One can only conclude that the private sector owners should not be allowed to operate publicly funded care homes because such companies seek to maximise profits at the cost of neglecting patient comfort and safety. Such behaviour appears to be rather common. The situation is even worse when we learn that these companies deliberately plan their businesses to avoid, quite legally, the payment of taxation for their profitable operations in Finland.

It is naive at best to believe that the Esperi Oy will spend huge amounts of money to make substantial and necessary improvements in their standard of care. That eminent and honest professors and other specialists have innocently been involved in writing a report for a company that has already behaved abominably. There is little reason to believe that their behaviour will change for the better.

Elderly people in their care deserve the best possible care from professional healthcare workers. These older folk are not in a position to defend their rights. The last government made up of the Conservative Party, the Center Party and the rump of the True Finns have acted dishonestly in allowing the private sector companies free access to publicly financed care of the elderly – and they should be censored. 

Do not forget that you too will be in an old folks’ home when you are older and frail… that is a sure thing, and not something you can avoid.

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